Journal Of Telemedicine And Telecare[JOURNAL]
Sun
200 papers
Experiences of patient-led melanoma surveillance and teledermatology in underserved groups in the Melanoma Self-Surveillance Trial: A qualitative sub-study.
Kharel P, Medcalf E, Ackermann D … +7 more , Williams J, Hersch J, Wu Z, Janda M, Drabarek D, Fann A, Bell K
J Telemed Telecare · 2026 Jul · PMID 42393858 · Publisher ↗
BackgroundPatient-led melanoma surveillance using mobile dermoscopy and teledermatology may support earlier detection and improve access to dermatology care for underserved populations.MethodsWe conducted semi-structured...
BackgroundPatient-led melanoma surveillance using mobile dermoscopy and teledermatology may support earlier detection and improve access to dermatology care for underserved populations.MethodsWe conducted semi-structured interviews with Melanoma Self Surveillance (MEL-SELF) Trial participants (control, intervention and run-in participants) to explore ways to support mobile teledermatology uptake among underserved populations. Participants had 1+ underserved population characteristics: age ≥70 years, residence outside major cities, low income, and Aboriginal and/or Torres Strait Islander (First Nations Australians) identity. We used thematic analysis to code data and report findings.ResultsOf the 22 participants (55% women; mean age 64.7 years), nine were ≥70 years, 13 lived outside major cities, four had low income and two identified as First Nations Australians (six had ≥2 characteristics). Participants valued the convenience of home-based skin checks, reassurance from expert feedback delivered via teledermatology and increased access to dermatology care. Family or partner support helped participants use the technology and examine hard-to-see areas, which increased confidence and adherence to the intervention. Barriers to skin self-examination included physical limitations, low confidence, and difficulties using the app or dermatoscope. Regional participants noted that teledermatology could potentially help reduce travel costs, provided additional clinic visits were not prompted by the teledermatology. Participants suggested that clear instructions and face-to-face training would facilitate uptake in practice, and that help from health professionals may also be beneficial.ConclusionTailored instructions, training, and technical assistance may help underserved groups use patient-led melanoma surveillance and improve their access to dermatological care.
Investigation of the validity and reliability of tele-assessment of upper extremity functions in individuals with stroke.
Hamaşoğlu LN, Doğru-Hüzmeli E, Dinç-Yavaş A … +3 more , Çalışır T, Duman T, Çetişli-Korkmaz N
J Telemed Telecare · 2026 Jul · PMID 42393846 · Publisher ↗
ObjectiveThis study aimed to investigate the validity and reliability of assessment tools used to evaluate upper extremity function in individuals with stroke using a tele-assessment approach.MethodsTwenty-four individua...
ObjectiveThis study aimed to investigate the validity and reliability of assessment tools used to evaluate upper extremity function in individuals with stroke using a tele-assessment approach.MethodsTwenty-four individuals with stroke (mean age: 61.13 ± 12.56 years), aged 18-75 years and classified as Brunnstrom stage ≥3 for upper extremity and hand function, were included. Upper extremity function was assessed using the Motor Activity Log-28 (MAL-28), Duruöz Hand Index (DHI), ABILHAND-Stroke Hand Function Questionnaire (ASQ), Nine-Hole Peg Test (NHPT), and Fugl-Meyer Upper Extremity Motor Assessment (FM-UE) using face-to-face and tele-assessment. Tele-assessment sessions were video-recorded and re-evaluated by the same physiotherapist after 3 weeks.ResultsThe NHPT completion times for the non-affected hand were significantly longer during tele-assessment than during the face-to-face assessment ( < 0.001). Agreement among face-to-face assessment, tele-assessment, and repeated tele-assessment was good for DHI dressing, NHPT non-affected hand, and FM-UE coordination and speed subscales (intra-class correlation coefficient (ICC) = 0.80-0.90), while all other measures showed excellent agreement (ICC > 0.90). Intra-rater reliability between tele-assessment and repeated tele-assessment was good for the FM-UE coordination and speed subscales (ICC = 0.834) and excellent for all remaining measures. The affected side (right/left) did not significantly influence tele-assessment outcomes ( > 0.05).ConclusionThe MAL-28, DHI, ASQ, NHPT, and FM-UE can be administered reliably via tele-assessment to evaluate upper extremity function in individuals with stroke. Tele-assessment represents a valid and reliable alternative for functional evaluations that can be conducted verbally and do not require physical guidance, particularly for individuals with limited access to healthcare services.
A systematic review and meta-synthesis examining the relationship between virtual communication and mental health outcomes of family members of intensive care unit patients.
Petchler CM, Parrillo E, Fisher MC … +4 more , Kruahong S, Wright RJ, Ornstein KA, Abshire Saylor M
J Telemed Telecare · 2026 Jun · PMID 42377060 · Publisher ↗
IntroductionEffective communication between family members, intensive care unit (ICU) patients, and healthcare providers is essential for easing family member's distress. We sought to understand how virtual communication...
IntroductionEffective communication between family members, intensive care unit (ICU) patients, and healthcare providers is essential for easing family member's distress. We sought to understand how virtual communication patterns between family members, ICU patients, and healthcare providers are related to the mental health outcomes of family members.MethodsWe systematically searched CINAHL and PubMed for peer-reviewed studies published between January 2015 and August 2024 that documented virtual communication with the family member of an adult ICU patient (e.g., phone calls, video calls) and used the family member's mental health as an outcome. Guided by the adapted Source, Channel, Message, Receiver, Outcome Model of Communication, quantitative mental health outcomes were categorized as "improved, neutral, or negative," and qualitative study findings were synthesized into themes.ResultsAmong 2,573 articles initially identified, 21 were selected for review. Phone and video calls were the most common communication modalities, and text messages were uncommon. Measured mental health outcomes included anxiety, depression, post-traumatic stress disorder, and stress or distress. Virtual communication was associated with either improved or no difference in measured mental health outcomes. However, meta-synthesis revealed two themes that suggest ways virtual communication can negatively influence emotions: (1) anxiety with variations in communication source, message, and frequency and (2) reassurance versus distress with communication modality.DiscussionPromoting communication through virtual communication strategies may improve mental health outcomes or emotions experienced among family members of ICU patients. ICU healthcare providers should consider tailoring virtual communication modality and frequency to family members' preferences.
Embodied care at a distance: How virtual consultations reshape bodily presence and trust in cancer rehabilitation in women with breast cancer or ductal carcinoma in situ.
Thestrup Hansen S, Weise J, Beck M
J Telemed Telecare · 2026 Jun · PMID 42377052 · Publisher ↗
IntroductionVirtual consultations are increasingly being used in cancer rehabilitation, yet little is known about how the virtual consultation format shapes patients' sense of embodied presence and relational care. This...
IntroductionVirtual consultations are increasingly being used in cancer rehabilitation, yet little is known about how the virtual consultation format shapes patients' sense of embodied presence and relational care. This study explores how women diagnosed with breast cancer or ductal carcinoma in situ experience rehabilitative virtual consultations with nurses and focuses on how virtual consultations influence bodily presence, body modalities, and relational interaction.MethodsAn exploratory qualitative study was conducted using semi-structured telephone interviews with fourteen women who had participated in a nurse-led rehabilitative virtual consultation one year after treatment. Using Braun and Clarke's Reflexive Thematic Analysis, we analysed the data with particular attention to how digital mediation reconfigured embodied presence and relational care.ResultsAcross the dataset, virtual consultations were experienced as altering body modalities and reducing embodied presence when bodily matters were addressed on-screen. Patients experienced vulnerability associated with the absence of physical co-presence and touch but also highlighted how the home environment created a sense of calm and safety. The analysis generated one overarching theme, , with four subthemes showing how virtual consultations continuously shifted between connection and disconnection, and how familiarity with the nurse supported relational grounding.DiscussionThe findings demonstrate that virtual consultations reconfigure embodied presence in cancer rehabilitation, which requires patients and nurses to negotiate new body modalities shaped by technology and by the environments from which they participate in the virtual consultation. These dynamics influence vulnerability, trust, and relational care, which underscores the need for digital health practices that recognize spatial embodiment and actively support embodied engagement at a distance.
Can digital navigators help reduce inequities in healthcare? A systematic review.
Ornellas G, de Albuquerque MV, Catapan SC
J Telemed Telecare · 2026 Jun · PMID 42331607 · Publisher ↗
BackgroundNavigating the healthcare system is complex. Care fragmentation is a major issue. Patient navigators have emerged to improve care continuity, especially for vulnerable individuals. With digital health expansion...
BackgroundNavigating the healthcare system is complex. Care fragmentation is a major issue. Patient navigators have emerged to improve care continuity, especially for vulnerable individuals. With digital health expansion, digital navigator (DN) roles have been created to foster digital literacy, access and equity.ObjectivesTo identify DN's roles in reducing health inequities and examine its terminology, professional background, training, techniques, skills, communication methods and outcomes.MethodologySystematic review across five databases. Data extraction included DN characteristics and outcomes. Thematic analysis compared expectations and findings.ResultsSixteen studies were reviewed. Findings suggest that the DN may help reducing inequities in healthcare access, though it is not guaranteed. Gaps were found in DN roles, competencies, training and terminology. Most studies emphasised technical support, communication and clinical integration, with limited focus on social issues. Disparities were noted between expected and reported roles.ConclusionThe DN role shows promise, especially in fragmented systems, but remains underexplored. Current approaches emphasise technology over social support. Broader understanding and implementation are needed.
Addressing high-utilizers of virtual urgent care through an EHR clinical decision support nudge.
Silberlust J, Roberts B, Leybov V … +2 more , Tran A, Genes N
J Telemed Telecare · 2026 Jun · PMID 42311072 · Publisher ↗
Virtual urgent care (VUC) has become an increasingly utilized resource for acute care delivery. Frequent utilization of VUC may reflect unmet longitudinal care needs and contribute to fragmented care. While high-utilizer...
Virtual urgent care (VUC) has become an increasingly utilized resource for acute care delivery. Frequent utilization of VUC may reflect unmet longitudinal care needs and contribute to fragmented care. While high-utilizer patterns are well described in emergency departments, they have not been systematically characterized in telemedicine. We evaluated a clinical decision support (CDS) nudge designed to identify and address high utilizers of VUC at a large academic health system. An electronic health record alert triggered when patients met predefined high-utilizer criteria (>3 visits in 30 days, >12 in six months, or >20 in 12 months) and prompted providers to document a structured follow-up plan using a SmartPhrase. Among 473 eligible patients, 162 (34%) received the SmartPhrase. After adjustment for baseline utilization using negative binomial regression, SmartPhrase use was associated with a 22% relative reduction in VUC visits over the subsequent 30 days (incidence rate ratio 0.78, = .03). Bootstrapped analyses confirmed a significant reduction in the SmartPhrase group (-1.47 visits; 95% CI [-2.19 to -0.62]), while no significant change occurred in the comparison group. These findings suggest that a low-cost, workflow-integrated CDS nudge may reduce short-term telehealth overutilization by prompting structured follow-up discussions and encouraging longitudinal care planning.
Remote triage and virtual urgent care services: A qualitative assessment of factors that impact triage decisions and outcomes.
Gray C, Lerner B, Egelfeld J … +3 more , Robinson J, Urech T, Vashi A
J Telemed Telecare · 2026 Jun · PMID 42240278 · Publisher ↗
BackgroundRemote nurse triage services are increasingly delivered through call centers to manage demand for urgent and unscheduled care. These encounters typically rely on decision-support tools, but safe and efficient o...
BackgroundRemote nurse triage services are increasingly delivered through call centers to manage demand for urgent and unscheduled care. These encounters typically rely on decision-support tools, but safe and efficient outcomes also depend on how nurses interpret patient information and make decisions about the most appropriate level of care. Despite the growth of tele-triage, nurse decision-making in this context remains underexplored.ObjectiveTo examine factors shaping triage decisions and outcomes in the U.S. Department of Veterans Affairs' (VA) national tele-triage and urgent care program.MethodsWe conducted semi-structured interviews with 39 participants, including triage nurses, nurse managers, and virtual urgent care providers, across six VA regions. Interviews explored decision-making processes, perceived challenges, and coordination between nurses and providers. Transcripts were coded and analyzed thematically.ResultsFour categories of factors influenced triage decisions: (1) technology-decision-support tools structured encounters but were limited by usability issues and risk-averse design; (2) professional training and judgment-nurses varied in critical thinking and remote assessment skills; (3) organizational priorities-policies emphasizing safety and liability restricted decision-making discretion; and (4) patient factors-preferences, beliefs, and situational constraints shaped acceptance of virtual care. Participants described tensions between efficiency and safety, and providers thought some Veterans' symptoms were more appropriately treated through primary care, reflecting institutional pressures.ConclusionsVA's tele-triage process is shaped by decision-support tools, nurse expertise, organizational priorities, and patient preferences. Algorithms provide structure, but effective triage depends on nurses' ability to interpret recommendations in context. As call center-based tele-triage expands, ensuring technology supports rather than constrains clinician judgment will be essential for safe, efficient, and patient-centered care.
Sustained use and determinants of telehealth in metropolitan cancer care: A multi-centre retrospective study beyond the COVID-19 pandemic.
Parsonson A, Cao J, Descallar J … +5 more , Xiong G, Karikios D, Boyle F, Lau AY, Yap ML
J Telemed Telecare · 2026 Jun · PMID 42227875 · Publisher ↗
IntroductionTelehealth use expanded rapidly in oncology during the COVID-19 pandemic, but determinants for ongoing use in metropolitan cancer care after the pandemic remain unclear.MethodsA multi-centre retrospective coh...
IntroductionTelehealth use expanded rapidly in oncology during the COVID-19 pandemic, but determinants for ongoing use in metropolitan cancer care after the pandemic remain unclear.MethodsA multi-centre retrospective cohort study of 271,889 oncology outpatient consultations (face-to-face, telephone, video) from 1 January 2019 to 30 June 2024 across four cancer centres in Sydney, Australia was conducted. Consultations were divided into pre-COVID, during-COVID restrictions and post-COVID restriction time periods. Multivariable generalised estimating equations modelled the odds of telehealth use in the during and post-restriction periods, testing interactions between time periods and key covariates.ResultsAcross 271,889 consultations with 21,125 patients the proportion of telehealth consultations was negligible pre-pandemic (0.4%), peaked during restrictions (24.7%) then reduced but was sustained post-restrictions (11.4%). Post-restrictions, telehealth use was more likely for follow-up consultations (vs new, < .001), medical oncology consultations (vs radiation, < .001), patients enrolled on a clinical trial ( < .001) and primary tumours including brain and genitourinary (vs breast, < .001). Patients from the most socioeconomically disadvantaged quintiles (vs highest, < .001), those who required an interpreter ( < .001), those receiving active treatment in the cancer centre (vs not on treatment, < .001) and with primary tumours including head and neck or skin (vs breast, < .001) were less likely to undergo telehealth consultations.ConclusionsThere is modest but sustained use of telehealth in oncology post-pandemic restrictions particularly for follow-up consultations, with less utilisation in populations experiencing disadvantage. Strategic, equity-focused policies are needed to ensure that telehealth use enhances, rather than exacerbates, disparities in access to cancer care.
Access to a telehealth falls prevention program: Mixed-method analysis from a health equity perspective.
O'Neil J, Dionne N, Sauve-Schenk K … +1 more , Savard J
J Telemed Telecare · 2026 Jun · PMID 42227854 · Publisher ↗
IntroductionAccess to falls prevention programs, addressing an important public health concern, is often limited for Francophone and Acadian minority communities. Technology has been used to deliver falls prevention prog...
IntroductionAccess to falls prevention programs, addressing an important public health concern, is often limited for Francophone and Acadian minority communities. Technology has been used to deliver falls prevention programs, but health equity factors linked to improving its access for all are still poorly understood. This study aimed to document health equity factors influencing access from the perspective of older francophone adults in various communities across Canada.MethodsGuided by the digital health equity framework, we used a sequential explanatory mixed method, including a descriptive sociodemographic questionnaire and semi-structured interviews, to document perspectives on access of persons who had completed different versions of a telehealth falls prevention program.ResultsSixty-one participants from five provinces completed the sociodemographic questionnaire, of which most participants ( = 45) represented perspectives from francophone communities living in a minority situation. Results revealed that 91% of participants had access to a computer or tablet with adequate audio-visual components for telehealth. Twenty of these participants, from four provinces, shared their perspectives. The majority of them reported that falls prevention programs should be offered in their preferred language and with different delivery options that consider the social and safety preferences of participants. Eight recommendations informing policy and implementation emerged.DiscussionAdvocacy around digital connectivity is essential to ensure that all Canadians have equitable access to high-speed internet connections and proper infrastructure. Participants also raised the importance of adapting services to their linguistic realities, geographic location, safety, and basic needs to optimize the impact of the health services provided to them.
Telerehabilitation versus face-to-face pulmonary rehabilitation in COPD: A systematic review and meta-analysis of comparative outcomes and delivery characteristics.
Luca Bamber J, Cook M, Cordier R … +3 more , Doma K, Parsons D, Speyer R
J Telemed Telecare · 2026 Jun · PMID 42227853 · Publisher ↗
ObjectiveTo compare the effects of pulmonary rehabilitation (PR) interventions delivered via telerehabilitation with face-to-face PR on functional capacity in individuals with chronic obstructive pulmonary disease (COPD)...
ObjectiveTo compare the effects of pulmonary rehabilitation (PR) interventions delivered via telerehabilitation with face-to-face PR on functional capacity in individuals with chronic obstructive pulmonary disease (COPD). Despite increasing use of telerehabilitation, uncertainty remains regarding its effectiveness and the influence of intervention characteristics.MethodsSearches of four electronic databases identified studies for a systematic review and meta-analysis comparing telerehabilitation with face-to-face PR interventions. Two independent reviewers screened 2292 records, with 280 full-text articles assessed for eligibility. Methodological quality was evaluated using Cochrane risk of bias 2 (RoB-2). Heterogeneity was accounted for using random-effects models. Subgroup analyses were conducted using mixed-effects models to explore the influence of intervention characteristics, including supervision and delivery mode.ResultsTwenty-eight studies met the inclusion criteria. Eight studies were excluded from within-group meta-analysis (two secondary analyses, two studies with insufficient data, and four studies with high RoB). Insufficient between-group data in two further studies resulted in 18 studies included in the between-group meta-analysis. Telerehabilitation interventions produced significant improvements in functional capacity, with a small pooled effect. Between-group analyses demonstrated that telerehabilitation achieved outcomes comparable to face-to-face PR, although findings should be interpreted in the context of moderate heterogeneity and variability in intervention design. Only one subgroup moderator, type of telerehabilitation support, was statistically significant, suggesting broadly consistent effects across most intervention characteristics.ConclusionFindings support the potential integration of telerehabilitation into routine PR delivery, with potential benefits including improved access for rural and underserved populations, greater convenience for individuals living with COPD, and opportunities for cost savings. However, the magnitude of the effect should be interpreted with caution given variability in intervention design and limited statistical power in subgroup analyses, and further high-quality studies are required to optimise intervention design and confirm long-term effectiveness.
Telepharmacy-based medication reviews for chronic diseases management: Identification of drug-related problems and pharmacists' perspectives.
Mohamad Ali AM, Karuppannan M, Sharif Mahadil SN … +1 more , Alfian SD
J Telemed Telecare · 2026 May · PMID 42217161 · Publisher ↗
BackgroundGlobally healthcare system is under increasing strain due to rising patient loads and growing demands of healthcare services. Telepharmacy has emerged as one of the strategies to improve access to pharmaceutica...
BackgroundGlobally healthcare system is under increasing strain due to rising patient loads and growing demands of healthcare services. Telepharmacy has emerged as one of the strategies to improve access to pharmaceutical care and reduce pressure on conventional health care delivery. However, research on telepharmacy remains limited, particularly studies that explore pharmacists' perspectives based on real-world service delivery.ObjectivesThis pilot study aimed to (1) identify the types of drug-related problems (DRPs) detected through telepharmacy medication reviews among patients with chronic diseases and (2) explore pharmacists' perspectives on the facilitators and challenges associated with providing telepharmacy services.MethodsA cross-sectional pilot study was conducted in two phases. In Phase 1, 215 participants underwent medication reviews via video conferencing, during which pharmacists documented DRPs using a structured form adapted from a Home Medication Review protocol. In Phase 2, pharmacists completed online open-ended surveys to share their perspectives. Quantitative data were analysed using descriptive statistics and Chi-square tests, while qualitative data were examined through thematic analysis.ResultsAmong 215 participants, 75.3% experienced at least one DRP. The most common DRPs were noncompliance (35.6%), adverse drug reactions (24.2%), and need for additional drug therapy (15.8%) suggesting that telepharmacy medication reviews may be particularly useful for detecting adherence- and safety-related concerns. Thematic analysis of pharmacists' feedback revealed five key themes: (1) enhanced accessibility and reach, (2) professional and operational benefits, (3) patient-related barriers, (4) technological and infrastructural challenges, and (5) professional and ethical concerns. These findings suggest that while telepharmacy can extend pharmaceutical care beyond conventional settings, its effectiveness depends on patient engagement, reliable digital infrastructure, and clear professional guidance.ConclusionTelepharmacy medication reviews may be a feasible approach for identifying clinically relevant DRPs, and extending medication management support. However, successful implementation requires attention to digital infrastructure, patient engagement, workflow integration, and ethical governance. These preliminary findings support further evaluation in larger, more rigorous studies.
Dedicated day surgery supported by remote patient monitoring for appendicectomy and cholecystectomy procedures: A cost-effectiveness analysis.
Kuwornu JP, Brain D, Ng KS … +8 more , Tariq A, Baysari M, Naicker S, Bamgboje-Ayodele A, Boscolo A, Hutchings O, Lee PJ, McPhail SM
J Telemed Telecare · 2026 May · PMID 42089733 · Publisher ↗
BackgroundManaging inpatient demand is challenging, especially for high-volume emergency surgical casemixes such as acute appendicitis and cholecystitis. These conditions drive unplanned admissions and consume significan...
BackgroundManaging inpatient demand is challenging, especially for high-volume emergency surgical casemixes such as acute appendicitis and cholecystitis. These conditions drive unplanned admissions and consume significant bed capacity, despite their suitability for accelerated pathways. We evaluated a bundled care model for this casemix, incorporating same-day discharge protocols and remote patient monitoring to reduce unnecessary inpatient stays and optimize hospital resources.MethodsA decision tree model compared the proposed same-day discharge surgical care model supported by remote patient monitoring with conventional inpatient care for suitable emergency department presentations requiring appendicectomy or cholecystectomy. The primary outcome was the number of inpatient bed days saved. Costs were estimated from the healthcare payer perspective in 2023 Australian dollars over a 12-month horizon. National datasets and published literature informed model inputs. Robustness was assessed using deterministic and probabilistic sensitivity analyses.ResultsThe same-day discharge surgical care model saved 0.57 bed days per patient (2.07 days for conventional inpatient care vs. 1.50 days for the same-day model) and reduced healthcare costs by AU$772 per patient (AU$9436 vs. AU$8664). Findings remained consistent across wide parameter variations in both sensitivity analyses.ConclusionThe proposed same-day discharge surgical care model supported by remote patient monitoring was a dominant strategy, achieving cost savings and reducing bed-day utilization compared with conventional inpatient care. These results highlight the potential of telehealth-enabled surgical pathways to improve hospital efficiency, optimize resource allocation, and advance digitally integrated models of perioperative care.
Increasing the use of video telehealth in residential aged care homes: A mixed-methods evaluation of a practical telehealth training program to support telehealth implementation.
Banbury A, Mendis R, Taylor M … +6 more , Kelly JT, Thomas EE, Caffery LJ, Haydon HM, Snoswell C, Smith AC
J Telemed Telecare · 2026 May · PMID 42089724 · Publisher ↗
IntroductionTelehealth in Residential Aged Care Homes (RACHs) is recommended to improve access to specialist health services. Successful telehealth adoption depends on reliable technical infrastructure, a skilled workfor...
IntroductionTelehealth in Residential Aged Care Homes (RACHs) is recommended to improve access to specialist health services. Successful telehealth adoption depends on reliable technical infrastructure, a skilled workforce, and revised models of care. This study aimed to evaluate the impact of a telehealth training program on RACH staff's knowledge and skills, telehealth uptake, related challenges and how to sustain its use.MethodA quasi-experimental design study. After delivering an onsite training program, we conducted t-tests with pre- and post-surveys, analysed feedback from training consultants, and performed follow-up interviews with RACH's senior managers.ResultsFrom August 2023 to October 2024, 41 RACHs received onsite telehealth training, primarily attended by nurses (88%). Survey results showed significant improvements in perceived telehealth knowledge, skills and confidence. A key motivator for implementing telehealth was enabling family members to attend consultations, while the major barrier was transitioning external health providers from phone to video consultations. In followup data, senior staff reported increases in telehealth activity and staff's confidence in using it, but potential for more activity. They wanted ongoing support, particularly to improve external providers' capability and willingness to use telehealth, indicating sustained telehealth adoption requires more than just access to equipment and training in RACHs.DiscussionTelehealth training can be effective in increasing knowledge, skills and confidence to use telehealth in RACHs. However, RACHs need ongoing training and support, especially given workforce challenges and staff retention issues. Engaging all stakeholders, particularly external service providers is crucial to ensure that telehealth-supported models of care are well integrated within the broader health system.
Effectiveness of telemedicine interventions on health outcomes in older adults with dementia: A systematic review of randomized controlled trials.
Zhang H, Zhi S, Fang S … +5 more , Li J, Li M, Lang J, Li D, Sun J
J Telemed Telecare · 2026 May · PMID 42084481 · Publisher ↗
IntroductionDementia prevalence is rising, imposing significant burdens on patients and caregivers. Telemedicine, encompassing devices, software, and videos, shows potential to address these challenges, but evidence on i...
IntroductionDementia prevalence is rising, imposing significant burdens on patients and caregivers. Telemedicine, encompassing devices, software, and videos, shows potential to address these challenges, but evidence on its effectiveness across dementia severities and intervention types remains unclear. This study aimed to systematically evaluate the effects of different telemedicine types on health outcomes in older adults with dementia using randomized controlled trials (RCTs).MethodsSix databases were searched through February 2026 for RCTs involving adults ≥60 years with dementia. Twelve studies (21500 participants) were included, assessing telemedicine interventions (video, device, software) versus usual care. Outcomes included cognitive function, activities of daily living (ADLs), depression, and caregiver burden. Risk of bias was evaluated via Cochrane RoB 2.0, and meta-analyses used RevMan 5.4.FindingsTelemedicine significantly improved ADLs ( = 2.63, < 0.05, =1%) but showed no effects on cognitive function, depression, caregiver burden, or transfer rates. High heterogeneity was noted in cognitive (=81.6%) and depression (=87%) analyses. Subgroup differences between video and device interventions were nonsignificant.ConclusionsTelemedicine modestly enhances ADLs in dementia but lacks broad efficacy across other outcomes. Variations in intervention content, population severity, and technological accessibility may influence results. Future research should stratify by dementia severity, tailor interventions to cognitive levels, and integrate caregiver-focused approaches to optimize telemedicine impact.
The use of telehealth technology in remote management of vestibular disorders: A scoping review.
Hutchins SJ, Howie J, Barr CJ … +2 more , Preen L, van den Berg ME
J Telemed Telecare · 2026 May · PMID 42080406 · Publisher ↗
BackgroundVestibular disorders affect approximately 34% of adults over the age of 50. Vestibular rehabilitation (VR) is ideally provided by trained clinicians; however, access can be limited, particularly in rural and re...
BackgroundVestibular disorders affect approximately 34% of adults over the age of 50. Vestibular rehabilitation (VR) is ideally provided by trained clinicians; however, access can be limited, particularly in rural and remote areas. Telehealth technologies offer alternative means of accessing healthcare. This scoping review aims to map use of telehealth technology in VR.MethodsA systematic search of five databases (CINAHL, Scopus, ProQuest, PubMed and Cochrane) was conducted to identify relevant qualitative and quantitative studies from 2010 to 2025. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Data were analysed and reported using a convergent segregated approach, in line with the Joanna Briggs Institute's methodological guidance for the conduct of mixed methods systematic reviews.ResultsForty-three articles were included. Telehealth modalities included smartphone applications ( = 18), telephone calls ( = 3), videoconferencing ( = 5), web applications ( = 14), and store-and-forward video technologies ( = 3). Telehealth technology was found to be accurate in recording oculomotor assessments and nystagmus, delivering canalith repositioning manoeuvres and undertaking outcome assessments. Improvements in health outcomes were demonstrated for subjective dizziness, balance, and oculomotor tests. Users reported telehealth technology to be feasible for remote VR with benefits including increased self-confidence with exercises, improved symptom awareness, and enhanced engagement and motivation for exercises.ConclusionsTelehealth technologies for VR show potential for improved health outcomes, diagnostic accuracy and positive user experience across a range of vestibular disorders. However, evidence for some vestibular disorders and telehealth modalities is limited by small sample sizes and a lack of studies. Further high-quality research is required in these areas.
Connected care: A telehealth and patient-reported outcome measure-based model for post-arthroplasty follow-up in a public hospital system.
McElwee B, Spiers L, Tirosh O … +3 more , Zaki C, Ng E, Tran P
J Telemed Telecare · 2026 May · PMID 42080401 · Publisher ↗
BackgroundRising demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) places significant pressure on healthcare systems. Routine in-person follow-up is resource-intensive and may limit access for new...
BackgroundRising demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA) places significant pressure on healthcare systems. Routine in-person follow-up is resource-intensive and may limit access for new or higher priority patients. The Connected Care protocol integrates telehealth with patient-reported outcome measures (PROMs) to support a more efficient and patient-centred model of post-operative care.MethodsOver 2 years in a public health institution, all THA and TKA patients completed routine pre-operative and post-operative PROMs. Patients scoring ≤27 on the Oxford hip score or Oxford knee score, and/or requested further clinical review, were triaged to telehealth consultation. Following telehealth assessment, patients were either booked for face-to-face review, discharged from routine follow-up, or managed with ongoing remote monitoring.Results1272 patients returned PROMs. Of these, 451 patients (35.5%) scored ≤27 and/or requested further review. Following telehealth consultation, 47 (10.4%) were discharged from face-to-face care, while 71 (15.7%) previously discharged had appointments reinstated for timely in-person review. Among 821 patients (64.5%) who scored >27 and did not request further review, 169 (20.6%) had pre-existing face-to-face appointments cancelled. Overall, the Connected Care protocol generated 216 additional orthopaedic outpatient appointment slots over the 24-month period.DiscussionPROM-guided telehealth triage enabled risk-stratified, patient-centred follow-up post-THA/TKA, improving outpatient capacity within a publicly funded orthopaedic service. It reduced low-value outpatient encounters while preserving access to face-to-face care when clinically indicated. Future development should incorporate post-operative radiographic review, extend the model to other orthopaedic pathways, and enhance cultural and linguistic accessibility to support equitable digital post-operative care.
Patient preference for telemedicine as an alternative to in-person community care in the Veterans Health Administration.
Garvin LA, Harvey KL, Keith McInnes D … +5 more , Zulman DM, Wray CM, Jacobs JC, Sista A, Meterko M
J Telemed Telecare · 2026 Apr · PMID 42043188 · Publisher ↗
IntroductionVeterans Health Administration (VA) funding of community care (i.e., non-VA clinicians contracted by VA) aims to improve access for veterans; however, community care expenditures rose five-fold from $7.9 bill...
IntroductionVeterans Health Administration (VA) funding of community care (i.e., non-VA clinicians contracted by VA) aims to improve access for veterans; however, community care expenditures rose five-fold from $7.9 billion to $40 billion between fiscal years 2014 and 2024. VA telemedicine offers a convenient, high-quality alternative to some types of community care. We examined patient preferences for VA video visit versus in-person community care.MethodsThis cross-sectional study combined primary data from a national survey of patients who received both VA and community in-person care plus VA video visits (April to June 2023) with VA administrative data. We assessed the proportion of patients who preferred VA video visits versus community care in-person, and reasons for preference. We used multivariate logistic regression to identify predictors of preference.ResultsFully 44% of patients had either no preference (24%) or preferred a VA video visit (20%) over a community in-person visit in future. Top reasons for preferring a VA video visit were: convenience, avoiding infection, shorter wait times, and VA care quality, further stratified across six service areas. Two significant predictors of preference for VA video care were: (1) having a prior positive VA video visit experience (odds ratio (OR) = 2.21, 95% confidence interval (CI) = 1.55, 3.14) and (2) having a prior negative community care referral and authorization experience (OR = 2.69, 95% CI = 1.10, 6.59).DiscussionContinued support for VA providers and patients in their digital training and device access for a positive telemedicine experience could encourage many patients among the millions referred to community care to stay with VA care.
A telehealth fracture clinic model for rural and remote communities: A retrospective review of the telehealth fracture clinic at mount Isa hospital.
Miyata N, Ogawa T, North JB
J Telemed Telecare · 2026 Apr · PMID 42029665 · Publisher ↗
BackgroundAccess to orthopaedic care in rural and remote regions of Australia remains limited due to geographic, logistical, and resource constraints. The Mount Isa Hospital Telehealth Fracture Clinic (TFC) was establish...
BackgroundAccess to orthopaedic care in rural and remote regions of Australia remains limited due to geographic, logistical, and resource constraints. The Mount Isa Hospital Telehealth Fracture Clinic (TFC) was established to address this disparity by delivering consultant-led fracture management via telehealth to communities across North-West Queensland.MethodsA 12-month retrospective clinical audit of the TFC was conducted from January to December 2023. Data on clinic activity, patient demographics, attendance, fracture characteristics, treatment pathways, and outcomes were analysed. Six-month periods were compared using chi-square tests. No significant difference was observed between the two periods (n = 1550, p-value from 0.15 to 0.66), and detailed subset analysis of the first 6 months was performed to evaluate fracture types and management outcomes.ResultsA total of 1550 patients were booked across 96 telehealth clinics, with an attendance rate of 67.1%. Indigenous patients accounted for 41.1% of referrals, reflecting substantial community need. Among 340 new patients analysed in detail, 91.2% completed management within TFC and were discharged locally; 5% required surgical intervention. Most fractures were stable upper limb injuries suitable for conservative management. The failure-to-attend (FTA) rate of 32.9% highlights the need for improved engagement strategies.ConclusionThe TFC model demonstrated high efficacy and accessibility, reducing patient travel and tertiary hospital utilisation while enabling more equitable access to orthopaedic care for remote communities. High FTA rates remain a challenge, highlighting the need for culturally responsive care models, digital literacy support, and community engagement. Telehealth represents a scalable solution for fracture management in geographically isolated populations.
Telemedicine in maxillofacial traumatology: A tertiary referral center 30-month experience.
Cascino F, Frosolini A, Latini L … +5 more , Benedetti S, Saloni E, Nocentini S, Cerase A, Gennaro P
J Telemed Telecare · 2026 Apr · PMID 42007806 · Publisher ↗
BackgroundMaxillofacial trauma requires timely recognition of urgent conditions, yet specialized expertise is often limited in rural settings. Hub-and-spoke trauma networks supported by telemedicine may optimize triage,...
BackgroundMaxillofacial trauma requires timely recognition of urgent conditions, yet specialized expertise is often limited in rural settings. Hub-and-spoke trauma networks supported by telemedicine may optimize triage, reduce unnecessary transfers, and integrate advanced workflows. Evidence for maxillofacial trauma teleconsultation, however, remains sparse.MethodsA retrospective study of all teleconsultations for maxillofacial trauma between January 2023 and August 2025 within the major trauma network of South-Eastern Vast Area of Tuscany (AV-TSE) (population ∼809,000) was conducted. Thirteen spokes hospitals from 13 peripheral Azienda Unità Sanitaria Locale Toscana Sud-Est (AUSL-TSE) are connected to the tertiary hub in Siena, for example, the Azienda ospedaliero-universitaria Senese (AOUS). Teleconsultations used a secure platform provided by (ESTAR) enabling safe exchange of clinical data, photographs/videos, and radiological images. Patients were triaged as emergency (immediate transfer), urgency (hub evaluation within 72 h), or elective (spoke follow-up). Primary outcomes were: avoided transfers, efficiency, and equity of access. Multivariable logistic regression assessed predictors of avoided transfer and loss to follow-up (LTFU).ResultsA total of 670 patients were analyzed (mean age = 64.4 years; 43.9% female). Zygomaticomaxillary complex (29.1%), orbital (19.4%), and maxillary fractures (15.1%) predominated. Overall, 174 patients (26.0%) were managed locally, avoiding ∼4520 km and 75 h of travel. Conservative outpatient care was most frequent (57.6%), while 13.7% required surgery under general anesthesia. Older age independently predicted both avoided transfer (OR = 1.03/year, 95% CI = 1.02-1.04) and LTFU (OR = 1.023, 95% CI = 1.010-1.035). No duplicate CT scans were required. Virtual surgical planning by computer-aided design (CAD) and computer-aided manufacturing (CAM) enabled preoperative workflows to begin before transfer, reducing delays.ConclusionsIn the experience of AV-TSE, a pragmatic telemedicine teleconsultation pathway between AOUS and AUSL-TSE decentralized one-quarter of cases, reducing transfers while ensuring safety. Integration with CAD/CAM planning enhanced surgical readiness. Improving follow-up reliability, especially in older patients, remains a priority for future network optimization.
A scheduling intervention to increase video visits in family medicine.
Pecina JL, Matthews MR, Paul MM … +3 more , Ehman KM, Capelle JJ, Rushlow DR
J Telemed Telecare · 2026 Apr · PMID 42007804 · Publisher ↗
IntroductionVideo visits in primary care have decreased significantly since their surge early in the COVID-19 pandemic.MethodsClinicians including physicians, nurse practitioners, and physician assistants in the Mayo Cli...
IntroductionVideo visits in primary care have decreased significantly since their surge early in the COVID-19 pandemic.MethodsClinicians including physicians, nurse practitioners, and physician assistants in the Mayo Clinic Department of Family Medicine were invited to dedicate one to two half-days per month exclusively to video visits. Schedules for these half-day sessions remained restricted to video appointments until the day prior. If at least 80% of slots were not filled by then, remaining openings were converted to in-person visits. If the half-day sessions were at least 80% full with video visits, clinicians had the option of performing these sessions remotely.ResultsOf 155 eligible clinicians, 34 (22%) participated voluntarily in this scheduling intervention. For the participating clinicians, the average video visit rate increased from 6.3% per month preintervention to 11.5% postintervention ( < 0.001). On a departmental level, the trend line for the percent of outpatient visits via video visit was decreasing by -0.1% per month preintervention. The postintervention slope of the trend line was 0.3% per month ( < 0.001). The majority (65%) of the time the half-day video visit schedules filled at least 80% and did not require conversion to allow in-person visits allowing clinicians to work remotely if they chose.ConclusionAllowing family medicine clinicians to perform 1-2 half-day schedules dedicated to only video visits increases the percentage of video visit performed per month both for individual clinicians and on a departmental level.
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